With a new presidential administration comes an opportunity to make a difference in the lives of gender-distressed people. Instead of being in lock-step with the LGBT activist agenda, which pushes for nonsensical laws and prioritizes gender reassignment to the exclusion of other treatment possibilities, the Trump administration could be a voice for those for whom gender reassignment is not the promised fix-all.

Progressive media activists promote changing genders as a safe, glamorous avenue to a wonderful new life. But I see the letters from those who are dissatisfied or even suicidal after a gender change, and someone needs to speak up for them. The suicide attempt rate of 41 percent in the transgender population is unacceptable.

As a former trans person, I hope that soon-to-be President Trump will encourage the medical community to consider the deeper issues causing the desire for hormone therapy and reassignment surgery. I have some suggestions for getting started.

Issue better medical guidelines. Establish a blue-ribbon team of doctors—internal medicine, psychiatrists, and endocrinologists—who have a history of questioning the current LGBT emphasis on gender change as the only treatment. Task the team with setting federal treatment guidelines focused on the emotional, psychiatric, and psychological needs of gender-distressed individuals and on treating underlying psychological disorders, suicide risk, depression, and anxiety. Investigate ways to reduce the number of unnecessary reassignment surgeries.

Use the power of the purse. Stop federal funding to any organization, such as medical facilities, public schools, and Planned Parenthood offices, if they do not comply with the guidelines. Redirect federal financial resources towards organizations that take a holistic approach.

Don’t Push People Into Things Many Will Regret

Let me explain why the Trump administration should reduce the current emphasis on immediate transition for those who are gender-distressed. More than 30 years ago I transitioned from male to female and lived as a female for eight years. In the first few days and months after the “change” I was 100 percent sure the gender transformation was a dream come true.

Like me, most people who make a gender change are happy at first. But as the years pass, for various reasons the idealized dream fails to become reality and the glamorous magazine version of life is gone. Depression takes hold and suicide looks good.

“Regret is rare,” say the activists. If they talk about dissatisfaction, suicides, and regret in the transgender population at all, they routinely blame the “transphobic” Right. Carol Costello of CNN interviewed me in 2015 at the height of the Caitlyn Jenner media frenzy. She listened respectfully to my story but then inserted a trans activist talking point: A Swedish study says only 2 percent of people regret their transition.

I have subsequently seen and heard this statistic bandied about, as if it were an indisputable truth. By digging into the source and looking at what other researchers say, a far higher number emerges.

The Swedish study Costello quoted measured regret by counting the number of transgendered people who later applied for reversal to the original sex (called a “regret application”). But as other researchers have pointed out, the 2.2 percent number doesn’t include the additional patients who died by suicide or made suicide attempts. Obviously, people who are happy with their life don’t try to end it. With those included, the number rises to 7.9 percent. That figure also doesn’t address those who regret their change but didn’t in the study interval apply to reverse it.

Other studies indicate a higher percentage of dissatisfaction. A 2004 United Kingdom review of more than 100 studies said: “Research from the US and Holland suggests that up to a fifth of patients regret changing sex.” That’s 20 percent, not 2 or 3. A recent systematic review of 28 studies examined outcomes of sex reassignment in 1,833 participants and found that from 16 to 29 percent of patients do not experience significant improvement in their gender dysphoria.

Regret Is Not Rare, It’s Common

As I have studied gender reassignment dissatisfaction over the last 10 years I’ve become convinced that the current treatment protocol of hormones and gender reassignment surgery ignores underlying problems. The issues go much deeper than a change of gender persona can reach or resolve.

Poor evaluations allow too many who lack psychological or emotional fitness to undergo gender reassignment surgery. Other factors like alcohol, drugs, and high-risk behaviors play a role in poor long-term outcome for the transgender population. As Richard B. Corradi, M.D., a professor of psychiatry at Case Western Reserve University School of Medicine, wrote recently: “People with a chronically unstable self-image, poor self-esteem, and an ill-defined sense of self are poorly equipped to deal with the stresses of ordinary life. This group constitutes the vast majority of the self-identified transgendered who undertake the full sex-change regimen of hormone treatment and ‘sex-reassignment’ surgery.”

Now to trans-advocates, Corradi’s words are “hate speech.” That means they hate the accurate assessment of a psychiatric doctor. Regardless, he’s not by any means an isolated case. Dr. Charles Ihlenfeld, after spending six years administering hormone therapy to 500 transgender patients in the 1970s, said the same thing: “There is too much unhappiness among people who have had the surgery. Too many of them end as suicides.”

“It’s not just a question of surgery or of screening out those who are psychotic or emotionally unstable; it’s the question of what the patient is going to do with the rest of his life that has to be resolved. Therapy can give him insight into himself and into his feelings that he needs to change his anatomical sex,” Ihlenfeld said. As a former transgender who underwent the complete gender reassignment protocol, I can tell you Dr. Ihlenfeld spoke the truth in 1979, but no one was listening. I attempted suicide after cross-gender hormones and a radical surgery.

Today I see similar regrettable outcomes of these protocols in the letters I receive, each one telling his or her own pain-filled, chilling story of dissatisfaction with being transgender, a label they no longer take pride in. Now they want a way back to sanity.

Corradi found chronically unstable self-image, poor self-esteem, and an ill-defined sense of self among transgender patients. How can a change of gender persona and appearance be a singular, permanent solution for people who suffer this way? The issues go much deeper for many such people.

Chris Hyde, the director of the University of Birmingham’s research facility (Arif) in the UK, said: “There is a huge uncertainty over whether changing someone’s sex is a good or a bad thing. While no doubt great care is taken to ensure that appropriate patients undergo gender reassignment, there’s still a large number of people who have the surgery but remain traumatized—often to the point of committing suicide.”

A large population-based study released in 2011 from Sweden (Dhejne et al. 2011) found that patients who underwent gender reassignment surgery had a much higher incidence of co-occurring (or comorbid) psychopathology, death by suicide, and suicide attempts.

Recent studies offer a possible explanation for the feeling that one needs to change anatomical sex. They show that two-thirds of transgender people have other co-existing psychological disorders. A 2014 study found 62.7 percent of patients diagnosed with gender dysphoria had at least one co-occurring disorder, and 33 percent were found to have major depressive disorders, which are linked to suicide ideation. Another 2014 study of transgender individuals in four European countries found that almost 70 percent of participants showed one or more Axis I disorders, mainly affective (mood) disorders and anxiety.

In 2007, the Department of Psychiatry at Case Western Reserve University in Cleveland, Ohio, in a clinical review of the comorbid disorders of patients interviewed at their Gender Identity Clinic, found that “90% of these diverse patients had at least one other significant form of psychopathology . . . [including] problems of mood and anxiety regulation and adapting in the world. Two of the 10 have had persistent significant regrets about their previous transitions.”

Stop Experimenting With Sad People’s Lives

The combination of 41 percent attempting suicide and 20 percent or more reporting dissatisfaction does not square with a community of happy and healthy people where “regret is rare.”

I would love to set the record straight to benefit people who are being led astray by false talking points. Surgical and hormonal gender reassignment is not without risk. Unhappiness with the outcome is not rare. To those who think transgender people are happy with their gender changes: Why, then, do they spend their days contemplating suicide?

Underestimating the level of dissatisfaction with gender change lulls lawmakers, medical personnel, and the patients themselves into experimenting with people’s lives.

I know from the letters I receive that too many people encounter dissatisfaction in post-surgical life and have nowhere to turn for help. For some, unhappiness is due to social difficulties, such as broken family relationships, divorce, loss of long-term relationships, or strain maintaining a career. For others, it’s attributable to the physical results: disappointment with the outcome of surgery or problems “passing” in one’s new gender.

Too many U.S. medical practitioners direct all gender-distressed people toward the extreme measures of conforming the body to the mind, rather than exploring the psychological issues that lie beneath the feelings. Underestimating the level of dissatisfaction with gender change lulls lawmakers, medical personnel, and the patients themselves into experimenting with people’s lives and making public policy based on a lie. It encourages an attitude of “There’s no harm in trying,” which is false. Giving powerful hormones and recommending radical surgeries without screening for psychological issues first causes great harm to the patients and their families.

It is not homophobic, transphobic, or bigoted to look at the causes of dissatisfaction and suicide among the transgender population. Rather, it is a caring, heartfelt way to prevent dissatisfaction and suicides. Improvement in treatment begins with acknowledging and using solid facts and statistics. Many people who are regretful and suicidal followed to the letter the generally accepted treatment protocol of doctor-prescribed hormone therapy and genital surgery.

President-elect Trump has an opportunity to change the transgender talking points and stop federal agencies from pushing the radical transgender agenda, opting instead to put the emphasis on giving gender-troubled folks access to well-rounded care that includes more than a quick path to cross-gender hormones and surgery.

Walt Heyer is an accomplished author and public speaker with a passion for mentoring individuals whose lives have been torn apart by unnecessary gender-change surgery.